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The Surgery Journey

 

Should I Consider Joint Surgery? (Step 1)

Before considering surgery, there are a number of other treatment options available for osteoarthritis (OA), including physiotherapy, exercise and weight management, as well as medication. However, if you’ve exhausted other options and are still seeking relief, you may be wondering if surgery is right for you. This resource will help you talk to your doctor about when surgery might be appropriate as well as the risks and benefits involved.

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Sources

This information was reviewed in June 2019 with expert advice from:

Dr. Sarah Ward, MD, FRCSC | Orthopaedic Surgeon, St. Michael’s Hospital
Assistant Professor, Department of Surgery, University of Toronto

Véronique Routhier, Physiotherapist | Hôpital Montfort

Preparing for Surgery Checklist (Step 2)

If you have your surgery date booked, use this checklist to help ensure you’re ready in the months and weeks leading up to your surgery. If you’re waiting for your surgery confirmation, there’s still plenty you can do to be prepared when the day arrives.

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Sources

This information was reviewed in June 2019 with expert advice from:

Dr. Sarah Ward, MD, FRCSC | Orthopaedic Surgeon, St. Michael’s Hospital
Assistant Professor, Department of Surgery, University of Toronto

So you’re having joint surgery. What should you expect? (Step 3)

Once you’re ready to move ahead with surgery, there are a few things you should know about what to expect from your procedure. The process, potential complications and even what the surgeon does can differ based on the type of surgery you’re having. Read on to learn more about what’s involved in different types of surgery.

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Sources

MyHealth.Alberta.ca 2018, https://myhealth.alberta.ca/health/tests-treatments/pages/conditions.aspx?hwId=aa14776
Healthline 2017, https://www.healthline.com/health/knee-arthroscopy
Arthritis-Health 2018, https://www.arthritis-health.com/surgery/knee-surgery/total-knee-replacement-surgical-procedure

This information was reviewed in June 2019 with expert advice from:
Dr. Sarah Ward, MD, FRCSC | Orthopaedic Surgeon, St. Michael’s Hospital
Assistant Professor, Department of Surgery, University of Toronto

What to do After Surgery? (Step 4)

Your surgery has taken place and you’re home from the hospital. Now your recovery can begin. Taking care of yourself and your joint after surgery will help ensure that you continue to benefit from the surgery and keep your joint healthy in the long-term. This care and attention starts the moment you return home from the hospital.

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Sources

https://orthoinfo.aaos.org/en/recovery/
https://orthoinfo.aaos.org/en/recovery/ https://www.peerwell.co/blog/2017/12/20/dealing-with-pain-after-hip-knee-replacement/
https://my.clevelandclinic.org/health/articles/15567-home-going-instructions-after-total-hiptotal-knee-replacement

This information was reviewed in September 2019 with patient input from a member of the arthritis community and expert advice from:
Dr. Sarah Ward, MD, FRCSC | Orthopaedic Surgeon, St. Michael’s Hospital
Assistant Professor, Department of Surgery, University of Toronto

Long-Term Functioning (Step 5)

After joint surgery, many people can perform daily activities more easily and with less pain. This can mean a better quality of life, improved mobility and increased strength. However, even though the initial recovery is complete, it is vital that you take care of your new and improved joint to ensure it continues to serve you well.

Optimizing Long-Term Outcomes

While your joint surgery may greatly improve your pain, mobility and function, it will not necessarily enable you to do more than you did before developing osteoarthritis (OA). In fact, it may not be appropriate to return to some of the activities you did before surgery.

If you had joint replacement surgery and are therefore living with a new knee, hip or shoulder, you may have an increased awareness of the joint and encounter occasional stiffness or “crackling” sounds. These are normal and do not indicate that the joint replacement surgery was not successful.

How long will the new joint last?

Most joint replacements last between 20 and 25 years. By taking care of your body and your joint, you could extend the life of the replacement joint even longer. Although you may have regained mobility and function, you should continue your exercises and weight management to keep the joint healthy and strong.

Revision surgery

In some cases, people who have had a joint replacement may need to have surgery at a later time to receive another new joint. This is called “revision surgery.” If you require a revision, it's likely that the first artificial joint has simply worn down over time or become loose, which can cause pain and dysfunction. Other reasons for revision surgery include an infection in the joint or a fracture around the artificial joint. It is very uncommon to need revision surgery in the first few years after the initial joint replacement, but that should not deter you from taking care of your new joint from the point of surgery onwards to ensure its longevity.

Access the PDF [226 kB]

Sources

https://orthoinfo.aaos.org/en/treatment/total-joint-replacement/
https://www.cihi.ca/sites/default/files/document/cjrr-annual-report-2019-en-web_0.pdf
https://www.arthritis-health.com/surgery/knee-surgery/post-surgical-knee-replacement-precautions-and-tips
https://www.healthpages.org/surgical-care/hip-replacement-road-recovery/

This information was reviewed in November 2019 with patient input from a member of the arthritis community and expert advice from:
Dr. Sarah Ward, MD, FRCSC | Orthopaedic Surgeon, St. Michael’s Hospital
Assistant Professor, Department of Surgery, University of Toronto

Exercise and Surgery

The best way to strengthen your legs, keep your heart and lungs fit and your energy levels high in preparation for surgery is to walk regularly. Don’t be afraid to walk in the months and weeks leading up to your surgery – it won’t harm your knee or hip joint. Follow the “two-hour” pain rule: If your joint hurts for longer than two hours after your walk, you have done too much. Do what you can to manage the pain and walk a bit less the next day. If weight bearing activity is limited by pain, consider using a bike or doing water exercises. Bicycling maintains mobility and joint lubrication, strengthens your quadriceps muscles, and provides a cardiovascular workout.

Besides walking, your surgeon may recommend that you do some regular pre-operative exercises. Some of these exercises are aimed at strengthening your arms and shoulders, which will help you manage crutches or a walker and getting in and out of chairs after surgery. Others will help maintain the strength of your leg muscles. 

Before starting any exercise program, check in with your healthcare team to make sure the exercises are appropriate for you. Perform exercises 3 days per week to build strength. Start with 1 set of 8 to 15 repetitions building up to 3 sets of 15 reps.

Benefits of Exercise in Recovery

It is important to continue exercises during the recovery phase of your surgery. Your care team will provide you with appropriate exercises, many of which may be similar to those found here. There are many benefits to exercising during your recovery, including:

Strengthening and stability
The goal of strengthening and stability exercises is to help you regain strength in the muscles around the affected joint and also in the rest of your leg, your trunk, your other leg and both your arms. For most recovery exercises, you may use special elastic bands or tubing for resistance training. If you have ready access to a swimming pool and if your surgeon says it is safe, water exercises may be added to your overall program. A bicycle can also help with strength and endurance.

Increasing your endurance
The goal is to help muscles in your legs, back, trunk and arms work more effectively over longer periods of time. Depending on your surgery, your physiotherapist may suggest you start pedaling on a recumbent bicycle (the type where you lean back against the seat) or upright bicycle.. As you recover, you may progress to a treadmill and to walking outdoors for progressively longer periods of time.

Sources

https://www.healthline.com/health/total-knee-replacement-surgery/exercises#thigh-squeezes
https://myhealth.alberta.ca/Alberta/Pages/phase1-exercises-before-knee-replacement-surgery.aspx 
https://sunnybrook.ca/content/?page=hip-knee-guide-staying-active-exercise

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This resource was made possible through an unrestricted educational grant from Pfizer.

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